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摘要:
目的 报道多发性骨髓瘤（multiple myeloma，MM）伴发骨髓淀粉样变实验室指标特征，进一步分析MM伴发淀粉样变患者实验室检查指标的变化。 方法 临床诊断MM患者44例，骨髓涂片刚果红染色结合偏振光确定淀粉样变，将MM划分为淀粉样变阳性和阴性两组。分别对两组进行全血细胞、血清酶及免疫球蛋白含量测定。同时依据细胞形态学分析两组骨髓各系幼稚与成熟细胞及骨髓瘤细胞数量。 结果 MM发现骨髓淀粉样变阳性患者免疫标志物IgG含量明显低于阴性组，κ和λ含量均值有降低趋势，但是未见统计学差异。淀粉样变阳性患者血清LDH和LDH1活性明显高于阴性组，而PT、Alb、PA、Glo、血液RBC、WBC和PLT数量等指标无统计学差异。 结论 MM患者免疫球蛋白IgG含量降低及LHD和LDH1增高有可能作为辅助检查MM骨髓淀粉样变的标志物。 Abstract:Objective Multiple myeloma (MM) complicated with bone marrow amyloidosis was previously reported. In this study, patients with MM complicated with amyloidosis were further analyzed using biochemical markers. Methods A total of 44 patients diagnosed with MM were included in this study. Bone marrow smears stained with Congo red were used and polarized light was utilized to detect MM with amyloidosis. These smears were then divided into two groups: amyloidosis positive and amyloidosis negative. In these groups, blood cell, serum enzyme, and immunoglobulin content were determined. The morphological characteristics of bone marrow cells and the number of immature, mature, and myeloma cells were analyzed. Results The immune marker IgG of the amyloidosis-positive patients with MM was significantly higher than that of the amyloidosis-negative group. Mean kappa and lambda contents decreased. Serum lactate dehydrogenase (LDH) and lactate dehydrogenase 1 (LDH1) activities in the amyloidosis-positive group were significantly higher than those in the amyloidosis-negative group. Significant differences were also observed in several biochemical markers, including PT, Alb, PA, and Glo. Likewise, the index numbers of peripheral blood RBC, WBC, and PLT were significantly different. Conclusion Immunoglobulin content was not correlated with amyloid deposition in patients with MM complicated with bone marrow amyloidosis. -
Key words:
- multiple myeloma /
- amyloidosis /
- bone marrow
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图 1 多发性骨髓瘤患者骨髓涂片淀粉样变染色（GR×200）
Figure 1. Stained bone marrow with amyloidosis of a patient with MM (GR×200)
A:Bone marrow subjected to Congo red staining. The arrow indicates the positive results; B:Bone marrow subjected to Wright's staining. The arrow indicates the myeloma cells
表 1 MM伴发骨髓淀粉样变血液细胞学特征
Table 1. Blood cell characteristics of a patient with MM complicated with bone marrow amyloidosis
表 2 MM伴发骨髓淀粉样变患者血清酶学活性
Table 2. Serum enzyme activities in a patient with MM complicated with bone marrow amyloidosis
表 3 MM伴发淀粉样变者血清免疫学特征
Table 3. Serum immunological characteristics of a patient with MM complicated with amyloidosis
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